If your workers' comp claim has been denied, or you have a dispute with the insurance company about your benefits, you can challenge the decision with the Rhode Island Workers' Compensation Court. (For an overview of eligibility and benefits, see our article on filing a workers' comp claim in Rhode Island.)
To start your appeal, you must file a petition with the Rhode Island Workers' Compensation Court. The Court has several petition forms available, depending on what issue is in dispute. If you are asking for workers' comp benefits, you should file an Employee's Petition for Compensation Benefits. You must pay a $20 filing fee and send a copy of the petition to your employer and its insurance company. For more information on filing a petition, check out the court's Frequently Asked Questions.
Once the court receives your petition, it will assign your case to a workers' compensation judge and schedule you for a pretrial conference within 21 days. At the pretrial conference, the judge will try to help you and the insurance company reach a voluntary settlement agreement. If that's not possible, the judge will issue a preliminary order as to whether you are entitled to benefits.
If you disagree with the judge's decision, you must act very quickly. You have only five days from the date of the decision to make a claim for trial. Otherwise, the judge's order will be final.
To request a trial, you must file a Claim for Trial within five days of the judge's pretrial order. You will have an initial hearing, during which the judge will identify the issues in dispute and go over the evidence to be presented at the trial. At the trial, each side will have an opportunity to present witnesses, submit documents, and make legal arguments. The workers' comp judge will review all of the evidence and then make a written decision in your case.
If you're not happy with the judge's decision, you can appeal to the Appellate Division. However, you must act quickly: You have only five days from the judge's order to file a Claim of Appeal to the Appellate Division. You will also need to request a transcript of the trial from the Workers' Compensation Court and send it to the Appellate Division.
This is a second level of administrative review, and a panel of three workers' comp judges will decide whether to uphold or reverse the judge's decision.
While you are permitted to represent yourself in the appeals process, the Rhode Island Department of Labor recommends being represented by a lawyer. The appeals process requires detailed knowledge of workers' compensation law and procedural rules, especially when it comes to presenting your case at a workers' compensation trial. For help finding a workers' compensation lawyer, check out our online lawyer directory.